Diabetes insipidus, commonly known as water diabetes, is a rare form of diabetes in which the kidneys produce unusually large amounts of diluted urine. It is diagnosed by administering a water deprivation test, which will reveal how the kidneys are functioning. There are four types of diabetes insipidus and they each have different causes. Each of the types also has different treatments.

Neurogenic diabetes insipidus is the first and most common type of the rare form of diabetes and is also referred to as central, hypothalamic, pituitary or neurohypophyseal diabetes insipidus. A lack of vasopressin, which is an anti-diuretic hormone, causes neurogenic diabetes insipidus. The condition cannot be permanently cured, but the symptoms can be treated. Neurogenic diabetes insipidus treatment consists of prescribing various drugs, including desomopressin (DDAVP), which is a synthetic form of vasopressin.

The second type of diabetes insipidus, nephrogenic, occurs when the kidneys are resistant to vasopressin and sometimes is referred to as vasopressin-resistant diabetes insipidus. The kidneys are unable to conserve water, which can lead to multiple complications, such as severe dehydration and in some cases death. Nephrogenic diabetes insipidus treatment requires drinking additional water to replace what the kidneys are unable to preserve.

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Some commonly used drugs, such as hydrochlorothiazide (HCTZ), which is sometimes combined with amiloride, and indomethacin, are used to reduce urine formation in nephrogenic diabetes insipidus, which decreases the amount of water required for drinking. The ultimate goal is to balance water intake with urine output. Another important component of treatment is eliminating salt from the diet. A combination of prescribed diuretics and a low-sodium diet are typically able to achieve the desired balance.

An abnormality in the part of the human brain that regulates thirst causes dipsogenic diabetes insipidus, which is characterized by abnormal thirst and drinking water excessively. People who are diagnosed with dipsogenic diabetes insipidus typically suffer from water intoxication and experience such symptoms as headaches, loss of appetite, nausea and sluggishness. As of 2010, there is no dipsogenic diabetes insipidus treatment, but some of the symptoms may be reduced with small doses of DDAVP before bedtime.

Gestational diabetes insipidus occurs when the pituitary becomes damaged or the placenta destroys vasopressin too quickly during pregnancy. Gestational diabetes insipidus treatment requires taking DDAVP. Women who develop gestational diabetes insipidus can expect symptoms to fade away between four to six weeks after delivery. Women should expect their symptoms to return with later pregnancies and will need to repeat treatment.

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